Endodontists Of Illinois | |
113 N Regency Dr Bloomington IL 61701-3515 | |
(309) 661-8900 | |
Not Available |
Full Name | Endodontists Of Illinois |
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Speciality | Dentist - Endodontics |
Location | 113 N Regency Dr, Bloomington, Illinois |
Authorized Official Name and Position | Nathaniel Blake Swaar (VICE PRESIDENT) |
Authorized Official Contact | 3096618900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Endodontists Of Illinois 113 N Regency Dr Bloomington IL 61701-3515 Ph: (309) 661-8900 | Endodontists Of Illinois 113 N Regency Dr Bloomington IL 61701-3515 Ph: (309) 661-8900 |
NPI Number | 1396164398 |
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Provider Enumeration Date | 04/08/2014 |
Last Update Date | 04/08/2014 |
Identifier | Type | State | Issuer |
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1396164398 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223E0200X | Dentist - Endodontics | 019028814 (Illinois) | Primary |
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